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Liposuction is a procedure designed to remove localized deposits of fat almost anywhere in the body. This technique uses small incisions and a high vacuum (suction) either combined with ultrasound or not to remove fat cells. This reduces contour in the regions treated.
Surgery Incisions approximately ½ inch in length are made in natural skin creases near the areas to be treated. A specially designed cannula (tube) is placed through the incision and into the area to be treated. The cannula is attached by tubing to a vacuum pump that removes the fat cells by suction as the cannula is moved under the skin. The procedure is now employed on all areas of the body including face, neck, abdomen, back, flanks, thighs, lower legs and arms. It is performed alone, on one or several areas at the same sitting, or in conjunction with other procedures. Fat distribution is determined by both heredity and diet. Heredity determines the location and number of individual fat cells. This is fixed and unchanged after puberty. Diet can increase or decrease the amount of fat in each cell but will not change the total number of cells or their distribution. Your appearance after liposuction will be influenced by your general state of health, the condition of your skin, age, weight and other factors. Liposuction is not a substitute for a healthy diet, nor is it useful for generalized weight reduction. Liposuction selectively removes fat only from those areas in which the patient desires a reduction. Since the actual fat cells are removed, the effect of the procedure is permanent. Following liposuction there will always be less fat in the treated area. Should you gain weight, following liposuction, you will tend to deposit fat in areas other than those treated. Skin Elasticity Healthy skin is desirable since it allows a smooth surface contour. Tight skin is seen in nearly all-young people and gradually is lost with age. Through middle age, however, we retain some elasticity. The skin will shrink to adjust to the reduced contour following liposuction. Cellulite Most people us the word "cellulite" to refer to dimpling and irregularities present on the skin surface. Most frequently it is present over the thighs and lower torso and worsens with age. There are many theories on cellulite. It is due to protein degeneration in the skin and its supporting structures. Liposuction will not cure cellulite. It will remove excess fat and thereby reduce contour and create a smoother appearance of the skin. Loose Skin and Musculature Some patients have loose skin and lax muscles with or without excess fat. These patients require additional procedures such as abdominoplasty (tummy tuck) or thigh lift to surgically remove excess skin and/or tighten lax muscles. During your consultation I will evaluate your skin and muscles as well as localized fat deposits. If you require an additional procedure to attain optimal results I will so inform you. Anesthesia When only one or two small areas are treated local anesthesia may be used. When multiple or large areas are treated general anesthesia is administered by an anesthesiologist. The anesthesiologist's services are billed separately. Duration of Operation The procedure will last from 30 minutes to 2 hours depending on how many areas are treated. Hospitalization vs. Office Surgery Patients having large amounts suctioned may stay overnight in the hospital. Admission is on the morning of surgery and discharge is usually in the late morning of the day after surgery. You will have either a private or a semi-private room while in the hospital. You may arrange for a private duty nurse. Patients having smaller areas suctioned may have ambulatory surgery, coming to the surgical facility on the morning of surgery and returning home on the same day. Before Surgery It is imperative that aspirin or products containing aspirin not be taken at least 3 weeks prior to surgery. Also refrain from any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center. You should shower well on the day of surgery prior to coming to the surgery center.
After Surgery After Surgery There may be small stitches, which will be removed in approximately 5 days. You will be placed in an elastic support garment immediately after surgery, and you will wear the garment continuously for 2 to 3 weeks. You may remove the garment to shower starting 24 hours after surgery. If your calves and/or ankles are treated, you will need to wear support hose for 6 weeks. You may experience some discomfort after surgery and pain medication will be given to eliminate or alleviate this. There is usually only mild discomfort after the procedure. You will be given a prescription for oral pain medication. I will see you the first day after surgery, at 1 week, 1 month, and 6 months after surgery. All patients may return to work after 1 week, although many may return to work earlier. Vigorous sports should be avoided for 3 weeks. If an additional procedure is performed to tighten skin, recovery will take longer. For the first week after surgery the treated areas will be swollen and will not show any reduction in contour. In fact, you may appear larger than prior to surgery. Your clothes may fit more tightly and you may actually weigh more. By the end of the first week, however, the swelling will begin to subside, and during the second week you will notice a diminution in contour and the treated areas will appear smaller than they were before surgery. Resolution of the swelling occurs rapidly after the third week, but your final improvement may not be apparent for as long as 3 months. If your calves and ankles have been treated, there will continue to be improvement beyond 3 months. Photographs Photographs, which do not include the face, are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post surgical photographs are also taken. Scars Liposuction scars are usually about ¼ inch in length, and are usually placed in natural skin creases or in other areas where they are inconspicuous or easily concealed by clothing or a bathing suit. In most patients the scars will appear red or dark for 6 months and will gradually fade thereafter until they are not noticeable by 9 to 12 months after surgery. The scars are rarely problematic. Nevertheless, you should be aware that all scars are permanent and their height, width and final color are unpredictable.
Complications SWELLING AND BRUISING All patients have bruising which will last from 3 to 6 weeks. A certain amount of numbness or reduced sensitivity may occur in the treated areas. As with any surgical procedure bleeding, infection, and other complications are possible, but are uncommon. CONTOUR IRREGULARITIES Patients may experience contour irregularities after surgery. Usually this is temporary but occasionally it may be permanent. Perfect symmetry is the goal, but small side-to-side differences may exist after surgery as they do normally. A very small percentage of patients will have secondary surgery after 6 months, most frequently for the removal of additional fat. This is may be done in the office under local anesthesia, but in some cases may require general anesthesia and be performed in a surgical facility. HEMATOMA A collection of blood under the skin is the most common complication. This may necessitate aspiration to drain the collection. Occasionally it will require additional surgery. INFECTION This is unusual. Superficial infection can sometimes be treated with topical antibiotic ointment. Deeper infections require antibiotics. A localized infection or abscess requires drainage and may affect the final outcome of the scar. WOUND HEALING PROBLEMS These include skin loss and fat necrosis. Skin loss and fat necrosis are rare but can occur in major suctions. It may require additional healing time and may create irregularities under the skin. In either case a scar revision at a later time may be necessary. Smoking decreases blood flow to the skin and may also be a cause of skin loss and slow wound healing. For this reason we recommend that you stop smoking for at least 3 weeks prior to surgery and for 3 weeks following surgery. PIGMENTATION CHANGES At times pigment changes may be obvious in the skin. Although uncommon, it is usually secondary to excessive bleeding under the skin resulting in deposition of blood pigments with in the skin. This could be a permanent change. PULMONARY EMBOLUS This is a blood clot, usually from your legs, that breaks off and travels to the lungs. This problem occurs rarely, and can follow any surgery, however, it can be life threatening. Obesity is the most commonly associated predisposing factor or when an enormous amount of suction lipectomy is performed at the same time. This is one reason that we generally do not offer this operation to markedly obese patients. Cigarette Smoking Smoking decreases blood flow to the skin and may result in delayed wound healing and possible skin loss. The risk of other complications rises as well. Smokers must stop completely at least 3 weeks prior to surgery and abstain for at least 2 weeks after surgery. Cutting down, but continuing to smoke, has no effect on reducing the rate of complications. Complete cessation of smoking is mandatory.
I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be. Should you not understand any of this information, or should you want further information, please call our office and ask. If necessary a second consultation can be scheduled.
Dr. Morales Recommends Theraderm Skin Products for his patients before and after surgery.
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